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Low carb or no carb - lessons learned...

Discussion in 'Type 1 Diabetes' started by Shannon27, Feb 20, 2020.

  1. Circuspony

    Circuspony Type 1 · Well-Known Member

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    My sister in law's cousin died at the age of 32 from a night time hypo that he didn't wake up from. Never knowingly had problems before that - but he'd been out with friends that night so alcohol was the probable cause sadly.
     
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  2. Rylando88

    Rylando88 Type 1 · Well-Known Member

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    Alcohol is known to make blood sugars drop, it can change depending on type of alcohol and the amount drunk, plus whatever insulin is in the background. This could explain why your sugars didn’t budge for a while because it would have been alcohol vs carbs until one side overtook the other!

    Glad you managed to get sorted, it can be a scary experience!!
     
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  3. porl69

    porl69 Type 1 · Well-Known Member

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    Plus when you drink alcohol, your liver can only do one thing at a time and getting rid of alcohol is its priority so it will not release glucagon into your system. **** you Liver
     
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  4. WJP1055

    WJP1055 Type 1 · Active Member

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    This is what the consultant told me in response to that question I asked when I was diagnosed in 1968. Thanks to that answer having a hypo (must have had hundreds by now) has never bothered me. It's just a routine now to take on carbs to get the BS back to normal.
     
  5. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    And they say women can multitask, tsk tsk tsk ;)
     
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  6. KK123

    KK123 Type 1 · Well-Known Member

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    Hmmmm, unless of course you're standing on the railway platform when it happens. Joking apart, that is a ridiculous thing for a Diabetes Consultant (without diabetes) to say. My Mum had several hypos and at least 50% of the time woke up in hospital and took days to recover. I also believe it's a myth to assume hypos cause no damage. My Consultant says they do especially if a person has several. x
     
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  7. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    Me too as a child, although i was mostly able to be treated at home. I tended to wake up just as the paramedics arrived :) met some lovely people in the meantime ha!
     
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  8. PeteN11

    PeteN11 Type 1 · Active Member

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    Can I ask why you think your Liver would do a dump in these circumstances? Surely if it was able to it would have already done some dumping when your levels were getting low and before it becomes critical which is the way it works for those without diabetes.

    I have had a similar sort of question over the last few months regarding lows and why they happen to us and will try to remember to ask at my next appointment.

    I have always been told that my Pancreas is not working and therefore does not produce insulin, hence the highs. Fair enough but it has never been explained to me why the Liver does not help out with the lows????? Is it because the Liver needs the hormone Glucagon to stimulate it and that is, or was, produced by my now defunct Pancreas?
     
  9. PeteN11

    PeteN11 Type 1 · Active Member

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    From what I have read Glucagon is not produced by the Liver but is the hormone needed by the Liver to dump Glucose in the event of a low. Glucagon is produced by the Pancreas which in my case doesn't do much at all anymore.
     
  10. EllieM

    EllieM Type 1 · Well-Known Member

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    Most T1s still produce glucagon (though T3cs with impaired pancreases may not) so they still have hypo protection from the liver. I think the problem occurs if the injected insulin is just too much for the liver (eg accidental overdose or liver impaired through alcohol). In general, though my pancreas no longer produces insulin it still produces other extremely useful hormones…. One reason why I wouldn't jump to have a pancreas transplant in the unlikely event that one was available.
     
  11. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    You probably already know this... but writing has helped me to figure it out :)
    The liver converts some of the sugar in the blood to glycogen and stores it. This is another type of glucose sugar. Glucagon (another hormone produced by the pancreas) is in charge of not letting the body's blood sugar levels getting too low. If they do, it stimulates the release of stored sugar from the liver into the bloodstream. A diabetic still produces glucagon, just because we don't produce insulin doesn't mean the pancreas is now little more than a useless floppy bit of tissue. It still regulates much of our body.
    When you've been drinking, you liver is focused on filtering the alcohol out of your bloodstream. If you go low, it doesn't have the capacity to both filter AND dump sugar unfortunately.
    Hope this helps?
     
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  12. PeteN11

    PeteN11 Type 1 · Active Member

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    So disregard the alcohol for a minute. Are you saying you never have lows, other than by having injected too much insulin?
     
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  13. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    I had to give you optimistic for that - if only!

    No, i still have lows even when i think i've done the right amount of insulin. There's so many factors involved - insulin sensitivity which goes up and down, activity, mood (if you're excited about something you have a faster heartbeat, so more sugar is used etc - over a period of time it can show in your readings) temperature (basically, don't use hot tubs, saunas and steam rooms without being prepared!), to name a few. The liver dump is only (to my knowledge) triggered by low blood sugars.

    However, if there's no alcohol or activities such as those listed above involved (ie. a normal day), lows do tend to be insulin related. Sometimes there is the odd one that makes no sense, but lows can generally be explained by diet/insulin combo. For example, lack of carbs, which contributed to this event for me. Lack of carbs and consequent hypo means you're on too much insulin. Even if its basal.

    Alcohol inhibits the liver dump process. Put simply, the liver can't multitask.
     
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  14. porl69

    porl69 Type 1 · Well-Known Member

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    Well explained @Shannon27

    Putting it basically YES. Mis calculating carbs content in a food or getting your timing of insulin wrong. The variables are endless
     
  15. KK123

    KK123 Type 1 · Well-Known Member

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    I agree and to give examples of those variables I would put it more like it being an impossibility to inject the exact right amount of insulin in the right spot at the exact right time to catch a spike followed by 4 hours of the body processing whilst calculating time of day and time of month and energy expended and general mood and how fast you walked and what you ate or didn't eat...well porl69, you get the idea! :)
     
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    #35 KK123, Feb 27, 2020 at 3:42 PM
    Last edited: Feb 27, 2020
  16. Pastelraven

    Pastelraven Type 2 · Newbie

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    I rarely get low reasons, more through luck than good management, but I always keep a good supply of jelly babies in the cupboard and if I have a low reading, I take 5 of these, and that does the trick.
     
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  17. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    If i go low i always have things in to self treat. I did that night. I had some gel which has always brought me back up within range before i have something else to eat. just this time, the gel wasn't enough and it took so long, despite everything i ate, to come back within range!
     
  18. PeteN11

    PeteN11 Type 1 · Active Member

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    I get that and it happens for all not just diabetics but what I was trying to pick up on was your statement below.
    It rarely gets dumped to stop a low because of all the other factors involved with diabetes especially the over use (mostly unintentional) of insulin which inhibits the flow of Glucagon.
     
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  19. bookworm01

    bookworm01 Reactive hypoglycemia · Member

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    If anyone is interested, this is the biochemical explanation for why alcohol can lead to severe hypoglycaemia (through inhibition of gluconeogenesis), especially when combined with a low carbohydrate diet and/or exogenous insulin: [​IMG]
     
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  20. CauthaFit2013

    CauthaFit2013 LADA · Member

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    The combination of Tresiba and alcohol will induce a hypo (for most people).
     
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